The term "encephalopathy" is derived from two Greek words "encephalon" and "pathos", which translates as "the brain" and "disease", respectively.

Encephalopathy is a diffuse brain injury syndrome, degenerative nature, tend to develop on the background of other heavy pathological process. Patients with a diagnosis of a decrease in the volume of nervous tissue and significantly impaired function.

This may be a congenital disease, which is a consequence of the adverse effects on the fetus in utero. Such a pathological condition can develop when genetic abnormalities that lead to abnormal development of the central nervous system, as well as under the influence of damaging factors like fetal hypoxia, birth trauma. Depending on the severity of the existing disorders early signs of the disease can be detected immediately after birth or after a certain time when you contact your pediatrician about those or other changes. As a rule, this type of encephalopathy have serious consequences and often leads to disability of the patient, but with proper and timely treatment of certain disorders may be adjusted due to the high compensatory abilities the child's body.



Acquired encephalopathy occurs more often. Its appearance may be caused by a variety of etiological factors. As a rule, acquired form arises because of the severe systemic diseases that lead to the development of ischemic brain cells.

The condition of a chronic lack of oxygen and glucose work of the central nervous system begins to falter, which over time leads to serious violations. Undoubtedly, these changes are more common in elderly patients.

The types and severity

Encephalopathy is a collective term that includes several varieties of pathological processes. So depending on the nature of the etiology and pathogenesis of the following species was isolated cerebral encephalopathy:

• encephalopathy;
• toxic encephalopathy;
• Wernicke's encephalopathy;
• hypertensive encephalopathy;
• leukoencephalopathy.

Severity of symptoms can vary from patient to patient. For convenience, the risk stratification of patients with specialists conditionally divided into three degrees of severity:

• I degree - is characterized by the presence of certain changes in the brain, detected by means of the study of instrumental methods of tissue, in the absence of clinical manifestations of the disease;

• Grade II - at this stage of the disease manifestations of disorders of brain activity are mild, or are hidden, intermittent;

• III degree - for this period is characterized by a pronounced neurological disorders generally resulting in a disability of the patient.

Causes

Experts identify the following etiological factors of cerebral encephalopathy:

• atherosclerotic vascular disease;
• arterial hypertension;
• vascular insufficiency;
• brain trauma;
• alcoholism (see alcoholic encephalopathy.);
• toxic chemicals, heavy metals;
• taking certain medications;
• drug use;
• pathology of pregnancy and childbirth;
• severe liver disease and kidney failure with the development of these organs;
• radiation exposure;
• metabolic disease agents, for example, diabetes.

Symptoms and signs

The clinical picture of encephalopathy can be quite variable and depends on the nature of the pathological process leading to brain damage. The most commonly in patients with this pathology occur following symptoms:

• dizziness;
• headache;
• irritability and instability of the psyche;
• sleep disturbance;
• noise in the head;
• memory loss;
• fatigue;
• loss of ability to concentrate;
• narrowing of the range of interests;
• tendency to depression or, on the contrary, to the euphoria and disinhibition to the lack of criticism to his condition;
• personality changes;
• violation of the innervation of the different areas of the body;
• tremor;
• sexual dysfunction;
• violation of facial expressions and zvukoproiznoshenija;
• ataxia;
• appearance of pathological reflexes;
• decreased hearing and vision;
• disorders of consciousness.

Diagnostics

It is carried out through a series of instrumental techniques:

• rheoencephalography - it is a non-invasive survey method to obtain information about the state of the walls of cerebral blood vessels. Carrying REG is a simple way to obtain enough information on the operation of arterial and venous vessels of the central nervous system;
• Doppler ultrasound - is a safe and highly informative methods for the diagnosis of vascular disorders that underlie the development of encephalopathy. When the focus UZGD specialist pays the study of carotid, vertebral, subclavian, and major cerebral arteries;
• MRI - is an indispensable method of examination of patients with symptoms of encephalopathy. For complete information under various clinical symptoms may need to perform an MRI of the brain vessels, head and neck (MRI angiography), cranial nerves, pituitary gland, eyeball, orbit. MRI tractography allows detection of abnormalities of white matter of the brain, due to congenital and acquired diseases;
• diagnosis of underlying disease - certainly for the purpose of effective treatment is required to determine the exact causes of encephalopathy. For this purpose are used in the clinic study a variety of methods by total blood analysis to liver biopsy.

Treatment

The choice of tactics of treatment of brain encephalopathy depends on the nature of the underlying disease that led to the defeat of the central nervous system. Only the correction of comorbidities possible to reduce or even eliminate some symptoms of encephalopathy.

• Correction of lifestyle - the elimination of risk factors for cerebrovascular disease plays a key role in the treatment of patients with dyscirculatory form encephalopathy. To increase the efficacy and reduce the rate of progression of the disease the patient is recommended to remove excess body weight, renounce the use of saturated fats, salt, observe the correct driving mode. Undoubtedly, the prevention of progression of encephalopathy is not possible without giving up smoking, alcohol and drug use.

• Drug treatment - to reduce the rate of progression of the disease allows antihypertensive, vasodilator and diuretic drugs. In addition to patients with a diagnosis of widely prescribed drugs group optimizers cerebral circulation and neuroprotective agents. In various embodiments, the disease state may require the introduction of other drugs, such as vitamin B1 in solution Wernicke encephalopathy.

• Surgical treatment - most commonly performed to correct vascular surgery, allowing to establish normal blood flow in the brain. The greatest efficiency and safety are different endovascular operations that are carried out without disturbing the integrity of tissues. So stenting of the carotid arteries in atherosclerotic lesions allows normal blood flow to the brain and prevents the progression of the disease.

• Physiotherapy - for the treatment of patients may be used technique of magnetic therapy, electromagnetic stimulation, electrophoresis with drugs, ultraviolet blood irradiation, ozone therapy, acupuncture. No less effective are treatments extracorporeal blood purification, such as plasmapheresis, hemosorbtion.

Implications and Forecast

The progressive course of the disease leads to inhibition of brain function and disability of the patient. However, with adequate and timely treatment, subject to the serious consequences of this disease to patients recommendations of experts can be avoided.